Artwork © 2015 Jocelyn Patrick

Incest & Sexual Abuse Aftereffects

E. Sue Blume(1998) asserts:

Incest has traditionally been defined as sex and/or marriage between close relatives. However, above all else, when children are involved, it is abuse — abuse of the child's personal and sexual boundaries by the very person(s) entrusted with her care. Sexual violation can occur through the way a child is talked to or looked at, even when there is no touching at all. Childhood sexual abuse (CSA), then, is any use of a minor/child to meet the sexual or sexual/ emotional needs of one or more persons whose authority is derived through ongoing emotional bonding with that child (parents, step-parents, babysitter, sibling, mother's boyfriend, teacher, priest, family doctor). Note that incest is an abuse of a power relationship, not a blood relationship; it is the violation of trust that damages the child.

NOTE: The following list is based on observation and interviews with incest survivors as well as work done by New York Women Against Rape. However, it is important to note that the following symptoms are also commonly found in adult survivors of sexual assault, whether or not the trauma occurred exclusively during childhood.

  1. Fear of being alone in the dark, of sleeping alone; nightmares, night terrors (especially of pursuit, threat, entrapment).
  2. Swallowing and gagging sensitivity; repugnance to water on one's face when bathing or swimming (suffocation feelings).
  3. Alienation from the body -- not at home in own body; failure to heed body signals or take care of one's body; poor body image; manipulating body size to avoid sexual attention.
  4. Gastrointestinal problems; gynecological disorders (including spontaneous vaginal infections; headaches; arthritis or joint pain.
  5. Wearing a lot of clothing, even in summer; baggy clothes; failure to remove clothing even when appropriate to do so (while swimming, bathing, sleeping); extreme requirement for privacy when using bathroom.
  6. Eating disorders, drug or alcohol abuse (or total abstinence); other addictions; compulsive behaviors.
  7. Self-destructiveness; skin carving, self-abuse.
  8. Phobias
  9. Need to be invisible, perfect, or perfectly bad.
  10. Suicidal thoughts, attempts, obsession (including "passive suicide").
  11. Depression (sometimes paralyzing); seemingly baseless crying.
  12. Anger issues: inability to recognize, own, or express anger; fear of actual or imagined rage; constant anger; intense hostility toward entire gender or ethnic group of the perpetrator.
  13. Splitting (depersonailization); going into shock, shutdown in crisis; a stressful situation always is a crisis; psychic numbing; physical pain or numbness associated with a particular memory, emotion (e.g., anger), or situation (e.g., sex).
  14. Rigid control of one's thought process; humorlessness or extreme solemnity.
  15. Childhood hiding, hangin on, cowering in corners (security-seeking behaviors); adult nervousness over being watched or surprised; feeling watched; startle response.
  16. Trust issues: inability to trust (trust is not safe); total trust; trusting indiscriminately.
  17. High risk taking ('daring the fates'); inability to take risks.
  18. Boundary issues; control,power, territoriality issues; fear of losing control; obssessive/compulsive behaviors (attempts to control things that don't matter, just to control something).
  19. Guilt, shame; low self-esteem, feeling worthless; high appreciation of small favors by others.
  20. Pattern of being a victim (victimizing oneself after being victimized by others), especially sexually; no sense of own power or right to set limits or say no; pattern of relationships with much older persons (onset in adolescence).
  21. Feeling demand to "produce and be loved"; instinctively knowing and doing what the other person needs or wants; relationships mean big trade-offs (love was taken, not given).
  22. Abandonment issues.
  23. Blocking out some period of early years (especially 1-12), or a specific person or place.
  24. Feeling of carrying an awful secret; urge to tell, fear of its being revealed; certainty that no one will listen; being generally secretive; feeling "marked" (the "scarlet letter").
  25. Feeling crazy; feeling different; feeling oneself to be unreal and everyone else to be real, or vice versa; creating fantasy worlds, relationships, or identities (especially for women: imagining or wishing self to be male, i.e., not a victim).
  26. Denial: no awareness at all; repression of memories; pretending; minimizing ("it wasn't all that bad"); having dreams or memories ("maybe it's my imagination"); strong, deep, "inappropriate" negative reactions to a person, place, or event; "sensory flashes" (a light, a place, a physical feeling) without a sense of their meaning; remembering the surroundings but not the event.
  27. Sexual issues: sex feels "dirty"; aversion to being touched, especially in gynecological exam; strong aversion to (or need for) particular sex acts; feeling betrayed by one's body; trouble integrating sexuality and emotionality; confusion or overlapping of affection, sex, dominance, aggression, and violence; having to pursue power in sexual arena which is actually sexually acting out (self-abuse and manipulation, especially among women; abuse of others, especially among men); compulsively "seductive" or compulsively asexual; must be sexual aggressor or cannot be; impersonal, "promiscuous" sex with strangers concurrent with inability to have sex in intimate relationship (conflict between sex and caring); prostitute, stripper, "sex symbol", porn actress; sexual acting out to meet anger or revenge needs, "sexaholism"; avoidance; shutdown; crying after orgasm; all pursuit feels like violation; sexualizing of meaningful relationships; erotic response to abuse or anger, sexual fantasies of dominance or rape (Note: Homosexuality is not an aftereffect).
  28. Pattern of ambivalent or intensely conflictive relationships (intimacy is a problem; also focus shifted from incest issues).
  29. Avoidance of mirrors (connected with invisibility, shame/self-esteem issues, distrust of perceived body image).
  30. Desire to change one's name (to disassociate from the perpetrator or to take control through self-labeling).
  31. Limited tolerance for happiness; active withdrawal from happiness, reluctance to trust happiness ("ice = thin").
  32. Aversion to making noise (including during sex, crying, laughing, or other body functions); verbal hypervigilance (careful monitoring of one's words); quiet-voiced, especially when needing to be heard.
  33. Stealing (adults); stealing and starting fires (children).
  34. The development of Dissociative Identity Disorder, Post-Traumatic Stress Disorder, or personality disorders
  35. Food sensitivities/avoidance based on texture (mayonnaise) or appearance (hot dogs), which remind the survivor of abuse, or smell/sound which remind survivor of perpetrator; aversion to meat, red foods.
  36. Compulsive honesty or compulsive dishonesty (lying)
  37. Hypervigilance regarding child abuse, or inability to see child abuse, or avoidance of any awareness or mention of child abuse; tendency to develop relationships with incest perpetrators

Note to therapists and others:
Many of these “aftereffects” can be the consequence of other problems that occur in early life. There are, however, some items which nearly always indicate childhood sexual abuse, and when one experiences over 25 of the items on this checklist, incest should be strongly suspected. Proceed with caution! (Survivors and partners, be gentle with yourselves—and each other.)

Blume, E. S. (1998). Secret survivors: Uncovering incest and its aftereffects in women. New York, NY: Ballantine Books. Retrieved from: